MEDICARE: DR. MANOJ KUMAR AGRAWAL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	ME99219	FL
2	207RI0011X	Interventional Cardiology Physician	ME99219	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689784365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANOJ KUMAR AGRAWAL M.D.

Provider Business Mailing Address
First Line	:	311 W OAK ST
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34741-4421
Country	:	US
Telephone Number	:	407-933-1423
Fax Number	:	407-933-7901

Provider Business Practice Location Address
First Line	:	311 W OAK ST
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34741-4421
Country	:	US
Telephone Number	:	407-933-1423
Fax Number	:	407-933-7901

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	02/15/2024

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